Page 7 - 2019AnnualConventionBrochure

Patient Driven Groupings Model Sessions
PDGM will bring revolutionary change to home health agencies. We’ve planned sessions to help you prepare.
A4 - PDGM - Changes Cannot Start Soon Enough! E5 - PDGM - Revenue Cycle Management Changes
Melinda Gaboury, COS-C, Co-Founder/CEO Melinda Gaboury, COS-C, Co-Founder/CEO
Healthcare Provider Solutions Healthcare Provider Solutions
Monday, April 29 | 10:30-12:00pm Tuesday, April 30 | 1:30-3:00pm
The most significant change in Homecare Reimbursement in CMS has provided some data on the revenue impacts and new PDGM
20 years will go into effect January 2020. The Patient Driven components, but there is more to be considered. Revenue Cycle,
Groupings Model (PDGM) is complicated, confusing, and from beginning to end, will require changes to adapt. Preparing now
overwhelming. CMS has provided some data on the revenue is essential in being prepared for the PDGM onslaught. This session
impacts and new PDGM components but there is more to will: outline how agencies will need to consider process changes in
be considered. Operational areas likely impacted under the their revenue cycle as a result of PDGM; outline potential strategies
new payment model include referral and sales management, for process revisions and adjustments to achieve a successful revenue
intake, revenue cycle, operational reporting, order and supply cycle transition under PDGM; outline billing process changes required
management, and much more. This session will highlight the by PDGM; and provide a checklist of things to begin implementing today
areas impacted and outline potential process changes to assist to be ready for a 2020 implementation.
in optimizing operations performance under PDGM.
F5 - PDGM is Coming - Is Your Agency Ready?
B6 - How Agency Outcomes Affect Star Ratings Under Sharon Harder, Consultant
Excel Health Group
PDGM Tuesday, April 30 | 3:15-4:15pm
Sue Payne, MBA, RN, CHCE
VP & Chief Clinical Officer, Corridor PDGM represents the most sweeping change to home health
Christopher Attaya, MBA, VP Product Strategy, SHP reimbursement in over two decades - and payment reform is affecting
other post-acute sectors beyond home health. The opportune question is
Data whether PDGM presents a threat or unprecedented opportunity! PDGM
Monday, April 29 | 1:45-3:15pm presents unique challenges to home health providers as they retool
This session will review how agency outcomes affect star operations to maximize reimbursement under a new set of rules as well as
understanding marketing opportunities that are presented by the effects
ratings under PDGM. A case study will be presented focusing of payment reform in other sectors of post-acute care. Join us for a session
on care of the patient with a specific primary diagnosis and devoted to understanding the opportunities presented by patient driven
differences between caring for the patient under PPS versus payment as we explore not only what PDGM will mean for NC home health
PDGM. Key areas of focus will be managing inappropriate agencies, but the opportunities that could be derived from payment reform
LUPAs under PDGM, cost effective approaches for improving initiatives affecting SNFs in NC markets.
functional status of patients under PDGM, and recommended
metrics to track under PDGM. G2 - Utilizing Technology to Ease the Burden of PDGM and the
Review Choice Model
Michael Griffith, SAE, Homecare Homebase
D3 - Episode Management in a PDGM World Paula Pitman, RN, BSN, MBA, AVP, Healthy@Home
Theresa Canziani, RN, BS Tuesday, April 30 | 4:30-5:30pm
Senior Clinical Consulting Manager, McBee Attendees have sat in on many presentations breaking down these
Tuesday, April 30 | 10:45-12:15pm regulatory changes. This session will be a time to provide actionable
tools to help providers handle the changes. We will highlight technology
CMS has provided some data on the revenue impacts and new available to ease the burden of the coming change. This will also be an
PDGM components, but there is more to be considered. Revenue opportunity for potential idea sharing as we open up topics to the audience
Cycle, from beginning to end, will require changes to adapt. to share various strategies being implemented.
Preparing now is essential in being prepared for the PDGM
onslaught. This session will: outline how agencies will need to We will want to cover questions like, “How can my agency...”:
consider process changes in their revenue cycle as a result of • See the overall impact of the rule on me?
• Ensure we don’t use codes that won’t be reimbursed in PDGM?
PDGM; outline potential strategies for process revisions and • Avoid LUPAs now that there is a LUPA range? Also avoid inappropriate
adjustments to achieve a successful revenue cycle transition under LUPAs in the second 30 day period since each 30 day period can be a LUPA.
PDGM; outline billing process changes required by PDGM; and • If appropriate, have the highest paying code as the principal diagnosis
provide a checklist of things to begin implementing today to be (CMS assumes agencies will do this and is how they justified the rule being
ready for a 2020 implementation. “budget neutral”)
• Bring in more comorbidities?
• Efficiently get my data submitted for RCM without having to add staff?
• Avoid the 25% reimbursement reduction with RCM? Implementation.

P1 - Plenary Session for Home Health:
Telling Your Patient’s Story for Review Choice Demonstration
Tuesday, April 30 | 8:45am-10:15am
Charles Canaan, RN, Senior Provider Relations Representative
Palmetto GBA
Review Choices Demonstration is on the way to North Carolina. The key to success
will be presenting the patient’s story in an organized manner. This session will focus
on how to provide the medical necessity details in order to get your pre-claim review
submission affirmed.

7 7